Panic Attacks: Symptoms, Causes, and What to Do

A panic attack can be terrifying, especially the first time it happens. Many people end up in emergency rooms convinced they're having a heart attack, only to be told their heart is fine — it was panic. Understanding what's actually happening in your body can make future episodes far less frightening.

What a Panic Attack Feels Like

Panic attacks typically peak within about 10 minutes and can include:
• A racing or pounding heart
• Chest tightness or pain
• Shortness of breath or feeling like you can't get enough air
• Trembling or shaking
• Sweating, chills, or hot flashes
• Dizziness or lightheadedness
• A choking sensation
• Nausea or stomach distress
• A feeling of unreality (derealization) or detachment from yourself (depersonalization)
• An intense fear of losing control, dying, or "going crazy"

Why Panic Attacks Happen

Panic attacks are your body's fight-or-flight system activating when there's no actual physical danger present. Common contributing factors include:
• Chronic or unresolved stress
• An anxiety disorder (though panic attacks can also happen without one)
• Major life changes or transitions
• Sleep deprivation
• Excess caffeine or stimulant use
• A history of trauma
• Genetics — anxiety and panic disorders can run in families
Sometimes a panic attack has an identifiable trigger. Other times, it seems to come "out of nowhere" — which itself can become a source of anxiety (fear of having another attack).

What to Do in the Moment

1. Remind yourself: this is dangerous-feeling, not dangerous. Panic attacks are intensely uncomfortable but not medically harmful.
2. Slow your breathing. Try inhaling for 4 counts, holding for 4, and exhaling for 6–8. Longer exhales activate your body's calming response.
3. Ground yourself in your senses. Name 5 things you can see, 4 you can hear, 3 you can touch, 2 you can smell, 1 you can taste. This pulls attention out of the spiral and into the present.
4. Don't fight the sensations. Trying to force panic to stop can intensify it. Instead, allow the wave to happen while reminding yourself it will pass.
5. Avoid leaving the situation abruptly if possible. If it's safe to do so, staying put (rather than fleeing) can help your brain learn that the situation wasn't actually dangerous.

After a Panic Attack

It's common to feel drained, embarrassed, or anxious about having another one. Be gentle with yourself — panic attacks are exhausting, and recovery (physically and emotionally) takes a little time.

When to Seek Support

If panic attacks are recurring, if you're avoiding places or situations out of fear of having one, or if you're constantly anticipating the next attack, it may be more than an isolated incident — it could be panic disorder, which responds very well to therapy.
If panic attacks are becoming a regular part of your life, a therapist can help you understand your triggers and build tools to reduce both their frequency and intensity.